IM Seizure Medication Effective for Status Epilepticus

Emergency Medicine News, 04/26/2012

Talan J – The study was designed to ensure that antiseizure medicines delivered through an autoinjector were not inferior to the IV approach. The primary outcome was the absence of seizures by the time they arrived at the emergency department. Secondary outcomes included endotracheal intubation, recurrent seizures, and the timing of treatment relative to when the prolonged seizures stopped.

Methods

Paramedics throughout the country were trained in the study protocol so they could decide whether a seizing patient was a candidate for the clinical study.

Enrollment was so smooth, study investigators said, that they had all of the patients they needed a year earlier than expected.

Results

The RAMPART investigators found that 73.4 percent of patients (329 of 448) in the group that received midazolam through the autoinjector were seizure-free by the time they reached the hospital compared with 63.4 percent (282 of 445) of those who were randomized to receive IV lorazepam (p<0.001 for noninferiority and superiority).